Active NPI
Intawell Behavioral Health LLC
- Counselor
- Sisters, OR
National Provider Identifier
1811629322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Legal business name
- INTAWELL BEHAVIORAL HEALTH LLC
- Practice address
- 895 E Coyote Springs Rd
Sisters, OR 97759-9518 - Phone
- (541) 668-5238
- NPI assigned
- Jun 24, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kelly Davis Martin
- Title
- Owner
- Phone
- (541) 668-5238
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
895 E Coyote Springs Rd
Sisters, OR 97759-9518
Mailing address
895 E Coyote Springs Rd
Sisters, OR 97759-9518
Phone (541) 668-5238
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656028800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1656028800000",
"number": "1811629322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "895 E COYOTE SPRINGS RD",
"city": "SISTERS",
"state": "OR",
"postal_code": "977599518",
"telephone_number": "541-668-5238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 E COYOTE SPRINGS RD",
"city": "SISTERS",
"state": "OR",
"postal_code": "977599518",
"telephone_number": "541-668-5238"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTAWELL BEHAVIORAL HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-24",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A",
"authorized_official_last_name": "DAVIS MARTIN",
"authorized_official_first_name": "KELLY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "541-668-5238"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sisters, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.